This Is What Actually Happens To Your Skin During A Chemical Peel
Botox and fillers may be the minimally invasive cosmetic procedures of our time, but the chemical peel is still going strong.
In simple terms, chemical peels use acid (there are different types) to break down the top layer, or layers, of skin to help diminish the look of fine lines, wrinkles and uneven skin tone. Believe it or not, chemical peels have been around since the mid-1800s, though they really seemed to gain mainstream popularity in the late ’90s and early 2000s. (We’ll never forget Samantha’s chemical peel on “Sex and the City.”)
Fast forward a decade or two, and roughly 1.4 million chemical peels were administered in the United States in 2017, according to a report by the American Society of Plastic Surgeons.
To learn more about the procedure and what exactly happens to the skin in the process, we spoke to Dr. Michelle Yagoda, Fifth Avenue facial plastic surgeon and integrative beauty expert in New York, and Dr. Elie Levine, a board-certified plastic surgeon and director of plastic surgery at Plastic Surgery & Dermatology of NYC.
Here’s what you should know.
First of all, not all chemical peels are the same.
“Chemical peels run a range of different types of products that can be used, and there’s a big difference in how deeply the chemical that’s being applied affects the skin,” Yagoda told HuffPost.
Yagoda further explained that there are three types of chemical peels ― superficial, medium-depth and deep-depth.
When people refer to chemical peels, Yagoda noted they’re usually talking about superficial peels (sometimes referred to as “lunchtime peels”). These are the mildest of the bunch, as they require little downtime. You may experience some redness for 20 minutes to half an hour afterward, and you may experience some dryness or flaking over the course of a few days, but otherwise, you can get back to business as usual. Typical acids used in superficial peels include glycolic, salicylic, kojic acid and malic acid, Yagoda said. Superficial peels are good for treating fine lines and wrinkles, large pores and dark spots, and to help tighten the skin.
Levine added, “If you have a big event, doing a light chemical peel a few days before is spectacular.”
Medium-depth peels generally use trichloroacetic acid at concentrations of 35 percent or less, Yagoda explained. These types of peels usually use a pure form of the acid that isn’t neutralized, and they aren’t typically made available for spa facials. Medium-depth peels can help treat skin that has a significant amount of photodamage, sun spots, mild to moderate acne scars, crepey skin under the eyes or dark circles.
The downside is the recovery period, which Yagoda noted runs anywhere from five to seven days. The skin is left raw and red, and needs to be constantly covered with ointment, though she said it shouldn’t be painful.
“That means, for those five to seven days, it’s fairly labor-intensive, because you’re gooey and putting on stuff all the time,” she said. “You can’t really go out.”
The deepest peels, which target more serious skin issues such as severe acne scars, excessive sun damage or looseness of the skin, also uses trichloroacetic acid, though at concentrations starting at 50 percent to 70 percent, or phenol acid, Yagoda said. She also noted that deep-depth peels may not be suitable for those with darker skin tones, as they could result in scarring or hypopigmentation. Typical downtime is about seven to 10 days, but could even last two weeks.
As Levine explained, for those who regularly get peels, the strength of each peel can be increased each time. As a result, the person’s tolerance increases, and over time, patients are able to get stronger peels with decreased downtime.
What actually happens during a chemical peel?
Before the actual peel, your doctor (or facialist) will clean the skin to remove any makeup, sunscreen and oil ― because as Yagoda told HuffPost, if there is oil on your skin, it “acts as a barrier and prevents the acid from getting in deeply.”
Levine told HuffPost that he also applies an ointment to the skin around areas like the eyes, nose and mouth, where you don’t want the peel to pool. He also uses a lip ointment to keep the mouth protected. Then comes the acid.
Both Yagoda and Levine explained that the length of time the acid stays on the face depends on the strength and type of peel. If it’s mild, Yagoda said, it will neutralize itself in a period of time, and then the patient is able to wash it off. If the peel is stronger, it requires a neutralizing agent to stop the acid from working.
During the peel process, the chemicals cause a reaction with the skin and dissolve the outer layers of dead skin to help even the skin tone and texture and promote the building of collagen, Levine explained.
The treatment causes a small injury to the skin, Yagoda said, which allows it to not only build new collagen, but to “regenerate itself and make fresh, new skin.”
What about at-home peels ― do they work?
Yagoda and Levine agreed that at-home chemical peels are effective, but the results are minimal. As you may expect, the strength of a peel you can buy over the counter is going to be much lower than what’s administered by your dermatologist or plastic surgeon. The effect of an at-home peel is similar to using a physical exfoliant or facial scrub, Yagoda said.
Still, she sees a benefit to using them.
“I am a very firm believer that when you get over the age of 40 and your skin starts to age more and lose a lot more collagen, elastin and oil, most people, unless you have very significantly oily skin, should change from a physical scrub to a chemical scrub because it’s more delicate on your skin,” she said. “There’s a lot less pulling and irritating of the skin to still get increased skin turnover and more rejuvenated skin.”
Is a chemical peel right for you?
Yagoda explained that chemical peels are just one method to regenerate and rejuvenate the skin. There are also light energy or laser treatments, or mechanical treatments such as dermabrasion.
“All three things really can cause the same benefit in skilled hands,” Yagoda said, adding that she prefers chemical peels “because it’s less expensive, it’s less painful and it’s quicker.”
If you’re interested in having a chemical peel, or perhaps wondering whether a peel is even right for you, you should consult a dermatologist or plastic surgeon who can advise you with their expertise. You can also try at-home peels, but know that you likely won’t see any drastic results.
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The One Who Loves Drugstore Cleansers
Her skin issue: Dryness. "I have really sensitive skin, and I'm just getting back into using a retinoid because this is the first time in 10 years I haven't been pregnant, trying to get pregnant or nursing," says Hirsch. (Experts recommend avoiding vitamin A derivatives like retinoid and tretinoins during pregnancy and nursing.) "I'm only using it every third night right now, and I'm peeling like crazy." That means her medicine cabinet is filled with ultra-hydrating products to help counteract that dryness and irritation. "You don't need a ton of stuff, but I probably play around with different products more than other people do."
Her Routine
Morning
1. Hirsch cleanses with a basic cleanser, "usually something you can find at the drugstore" she says. The three in her rotation right now: Neutrogena Fresh Foaming Cleanser, First Aid Beauty Face Cleanser and Dove Beauty Bar Sensitive Skin.
2. She applies sunscreen, and, yes, she really does use it every day. "My skin is basically translucent," she says, so she only uses products with SPF 30 or greater. Her three favorite sunscreens: Shiseido Ultimate Protection Lotion WetForce for Sensitive Skin and Children, EltaMD UV Clear Broad-Spectrum SPF 46 (she likes to mix this untinted sunscreen into her BB cream for protection and coverage) and La Roche-Posay Anthelios 60 Ultra Light Sunscreen Fluid. She also frequently borrows Babo Botanicals Nutri-Soothe SPF 15 Lip Treatment from the diaper bag.
Night
1. She cleanses again, usually with the same cleanser she used that morning.
2. Every third night, she applies a prescription retinoid called Refissa ("the gentlest retinoid you can get," she says) to address aging-skin concerns like fine lines and pigmentation. But every night, she puts on a double dose of skin soothers: first, Skinceuticals Hydrating B5 Gel, then First Aid Beauty Ultra Repair Cream. "When I finish up the Repair Cream, I'm going to swap it for Fresh Elixir Ancien," she says, a hydrating face oil that also minimizes wrinkles.
Extras
"Every now and then, if I'm feeling motivated, I'll use a moisturizing mask or an eye treatment like Shiseido Benefiance WrinkleResist24 Pure Retinol Express Smoothing Eye Mask," she says. Or she'll apply a bit of Peter Thomas Roth Oilless Oil Purified Squalene Treatment, another, you guessed it, hydrator.
The One Who Can Relate to Your Breakouts
Her skin issue: Oil, which leaves her with blemishes. "I use acne products twice a day," Lamb says. "On the upside, people with oily skin also tend to look younger." (Gotta love that positive attitude.) That being said, she's starting to notice the signs of time on her face, so anti-aging products are now a priority.
Her Routine
Morning
1. Lamb starts by cleansing with La Roche-Posay EffaClar Gel Purifying Foaming Gel Cleanser or M-61 Power Cleanse.
2. After applying a prescription acne medication, she uses either La Roche-Posay Effaclar Mat Oil-Free Mattifying Moisturizer ("when I'm feeling really oily") or Dermalogica Intensive Moisture Balance. If her skin seems dry in the a.m., she'll switch to a heavier moisturizer, like SkinCeuticals Emollience. Here's what's not in her daily morning routine: sunscreen. (Try to contain your horror). "The only time I'm outside during the day is early in the morning when I walk to work, so I get very minimal sun exposure," she says. Plus, "I'm a darker-skinned black woman, so I don't feel as wedded to the sunscreen recommendations that I make to patients who don't have my complexion."
Night
1. She washes with the same cleanser, but this time, she uses a Clarisonic Mia brush to really get the grime of the day out of her skin.
2. Lamb applies a pea-sized amount of a topical prescription retinoid to her face, which targets both wrinkles and acne. "I always follow that up with one of the thicker moisturizers from my morning routine, either the Dermalogica or the Skinceuticals," she says.
3. In the past year, Lamb has started noticing unwelcome changes around her eyes. "I've been getting Botox on my forehead and around my eyes every six months for the past 10 years, but that doesn't help with under-eye bags, which is what I'm seeing in the mirror now." Eye cream has become a part of her daily routine—her favorite is RéVive Moisturizing Renewal Eye Cream, though sometimes she'll do an eye mask like Sisley Eye Contour Mask instead. "You want something with good moisturizers, so it can plump up the area under the eye and reduce the appearance of bags."
Extras
A couple of times a week, Lamb will use the M-61 Fast Blast 2-Minute Vitamin C Facial Mask in the shower, and occasionally she'll also use her Clarisonic to exfoliate with Dermalogica Daily Microfoliant. Both help give her skin a little glow, she says.
The One With the Minimalist Routine
Her skin issue: Rosacea, which means her skin "gets red, sensitive and breaks out sometimes," she says. Gentle anti-inflammatory products help keep it under control.
Her Routine
Morning
1. Tanzi uses the same cleanser she's used for 15 years—Donell Cream Wash. "It's gentle enough for patients to use after laser procedures, so it's great for my sensitive skin."
2. "I follow up my cleanser with a little antioxidant serum, SkinCeuticals C E Ferulic," she says. "It's anti-inflammatory, and it also layers well under sunscreen."
3. Makeup with built-in sunscreen is the last thing Tanzi applies before she walks out the door. Specifically, Colorscience Sunforgettable Brush-on Sunscreen SPF 30. "It goes on like a pressed powder, has a little color to it and you can touch it up throughout the day," she says. "I put one in every bag I own."
Night
1. She washes with Donell Cream Wash again, then applies an eye cream with peptides to promote collagen production and smooth out wrinkles (her go-to is Alastin Restorative Eye Treatment).
2. Next comes the anti-aging treatment. "I'm a big proponent of layering a retinol under a glycolic acid product, or doing them on alternate nights if your skin can't handle retinol every night," says Tanzi. She chooses to layer them. Her retinol product is iS Clinical Pro-Heal Serum Advance+, "just a couple of drops for the whole face." Finally, her moisturizer, Epionce Renewal Facial Cream, has glycolic acid to lessen fine lines and wrinkles.
The One Who's All About Anti-Aging
Her skin issue: Minimizing the signs of aging. In addition to consistent sunscreen use and topical retinoids, "I've had noninvasive radiofrequency tightening treatments and dermal fillers regularly over the last few years to address concerns like eye bags and sagging skin," says Chapas. "I also really like laser resurfacing, which removes damaged skin cells and replaces them with new ones."
Her Routine
Morning
1. After she gets out of the shower, Chapas applies Neocutis Micro Firm Neck & Décolleté Rejuvenating Complex to her neck and chest to firm the area and reduce the appearance of "dreaded neck lines," she says.
2. Next, she washes her face with a mild cleanser like Cetaphil Gentle Skin Cleanser, then uses antioxidant-rich SkinCeuticals C E Ferulic, "which not only provides some SPF," she says, "but it also helps undo sun damage like discoloration."
3. She follows up that serum with Restorsea Renormalizing Serum, which exfoliates to help even out pigmentation, and tops it all with SkinCeuticals Blemish + Age Defense on her T-zone to unclog and minimize pores.
4. At some point before she leaves the house, Chapas also puts on EltaMD UV Clear Broad-Spectrum Sunscreen SPF 46. "It can go anywhere in the routine because physically blocking sunscreens, like this one, don't have to be absorbed into the skin to be effective," she says.
Night
1. After washing her face with Cetaphil again, Chapas applies SkinMedica Retinol Complex 0.5 to reduce fine lines and even out skin tone.
2. The morning's chest-and-neck cream gets a second use, this time as Chapas's nightly moisturizer.
The One Who's Serious About Makeup Removal
![<i>Jessica Wu, MD, a clinical assistant professor of dermatology at University of Southern California Keck School of Medicine</i> <br /><br /><strong>Her skin issue:</strong> Eczema, which means she's careful about using overly drying products or cleansers that might strip the natural oils off her skin, which can lead to flare-ups. <br /><br /><strong>Her Routine</strong> <br /><br /><strong>Morning</strong> <br />1. "I don't always cleanse in the morning," says Wu. "Usually I just splash my face with lukewarm water in the shower, but if I'm feeling oily, I'll wash with <a href="http://www.bioderma.com/en/our-products/sebium/h2o" target="_blank">Bioderma Micellar Water.</a>" <br /><br />2. Next, Wu uses <a href="http://www.robinmcgrawrevelation.com/products/omg-really-me" target="_blank">Robin McGraw Revelation OMG Is This Really Me Serum</a> [disclosure: Wu recently became the chief medical advisor for Robin McGraw Revelation], which she applies anywhere she's starting to notice crepey-ness and fine lines—under the eyes, on the smile lines and the upper lip, in particular. <br /><br />3. Sunscreen isn't an everyday must for Wu, because "I leave for the office before the sun is up and I'm there until 7 p.m." But on the weekends, she uses the <a href="http://www.vichy.co.uk/sun-protection/stick-spf-50-ideal-soleil/p16837.aspx" target="_blank">Vichy Ideal Soleil Stick SPF 50+</a>. "It's waterproof and doesn't budge," she says. <br /><br /><strong>Night</strong> <br />1. Wu wears foundation and eye makeup daily, so the first thing she does at night is use the Bioderma Micellar Water to take everything off. "I get five round cotton pads, soak them with the water, then use the first two to take off my eye makeup, then the third and fourth to take off the rest of my makeup, and I use the fifth pad as a toner. It leaves my skin soft and clean but not stripped," she says. <br /><br />2. On Mondays, Wednesdays, and Fridays, Wu applies a thin layer of a prescription tretinoin called <a href="https://www.obagi.com/patients/product-line/renova" target="_blank">Renova</a>. "It stimulates collagen production and helps control my oil and monthly hormonal breakouts," she says. <br /><br /><strong>Extras</strong> <br />Once a week, Wu does a deeper cleanse using <a href="http://www.ulta.com/hydrating-cleanser?productId=xlsImpprod4190255" target="_blank">Cerave Hydrating Cleanser</a> and a konjac sponge like the <a href="http://www.sephora.com/konjac-cleansing-sponge-P382345" target="_blank">Boscia Cleansing Sponge</a>. "You can also find them at your local Asian food store for about $2," she says. Then, every two to three weeks, if her skin is really dry or she feels an eczema flare coming on, she'll apply the hydrating <a href="http://www.sephora.com/facial-treatment-mask-P375852?skuId=1448455&icid2=lp_sk2_bestsellers_carousel:p375852" target="_blank">SK-II Facial Treatment Mask</a>.](https://s.yimg.com/ny/api/res/1.2/dLF4CN_eaBTh3DH58KRevg--/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MA--/https://img.huffingtonpost.com/asset/58503288120000dd00eef100.jpg)
Her skin issue: Eczema, which means she's careful about using overly drying products or cleansers that might strip the natural oils off her skin, which can lead to flare-ups.
Her Routine
Morning
1. "I don't always cleanse in the morning," says Wu. "Usually I just splash my face with lukewarm water in the shower, but if I'm feeling oily, I'll wash with Bioderma Micellar Water."
2. Next, Wu uses Robin McGraw Revelation OMG Is This Really Me Serum [disclosure: Wu recently became the chief medical advisor for Robin McGraw Revelation], which she applies anywhere she's starting to notice crepey-ness and fine lines—under the eyes, on the smile lines and the upper lip, in particular.
3. Sunscreen isn't an everyday must for Wu, because "I leave for the office before the sun is up and I'm there until 7 p.m." But on the weekends, she uses the Vichy Ideal Soleil Stick SPF 50+. "It's waterproof and doesn't budge," she says.
Night
1. Wu wears foundation and eye makeup daily, so the first thing she does at night is use the Bioderma Micellar Water to take everything off. "I get five round cotton pads, soak them with the water, then use the first two to take off my eye makeup, then the third and fourth to take off the rest of my makeup, and I use the fifth pad as a toner. It leaves my skin soft and clean but not stripped," she says.
2. On Mondays, Wednesdays, and Fridays, Wu applies a thin layer of a prescription tretinoin called Renova. "It stimulates collagen production and helps control my oil and monthly hormonal breakouts," she says.
Extras
Once a week, Wu does a deeper cleanse using Cerave Hydrating Cleanser and a konjac sponge like the Boscia Cleansing Sponge. "You can also find them at your local Asian food store for about $2," she says. Then, every two to three weeks, if her skin is really dry or she feels an eczema flare coming on, she'll apply the hydrating SK-II Facial Treatment Mask.
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This article originally appeared on HuffPost.
